Pepper Commission Report: Hearing Before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundred First Congress, Second Session on Recommendations of the Pepper Commission Regarding a Public Program for Long-term Care Services, June 14, 1990, Part 1

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Page 56 - A small but socially significant percent of. the uninsured population is comprised of " nonpoor persons who are unable to purchase private health insurance because they are substandard health risks. The US Chamber of Commerce supports federal legislation which would require establishment of state pools for uninsurable individuals, with losses financed by state general revenues or other broad based funding. Thus far, 16 states have established such risk pools. V. PROPOSAL- PROMOTE EXPANDED VOLUNTARY...
Page 139 - Insurers with more liberal enrollment practices then lose their low-risk enrollees — who can find better-priced coverage elsewhere — and keep their higher-risk enrollees, who have nowhere else to go. These carriers thus are left with risk pools that gradually deteriorate over time...
Page 55 - ... WITHIN A REASONABLE PERIOD OF TIME, AS PART OF A LONG-TERM COMMITMENT TO UNIVERSAL FINANCIAL ACCESS TO CARE The Chamber supports, as a long-term goal, a system of public and private insurance that would assure universal financial access to appropriate health care. Even while the nation searches for the means to achieve that long-term goal, the Chamber supports immediate action to lessen the number of uninsured through a mix of public and private initiatives. A reasonable target for such short-term...
Page 146 - ... o A smaller base of employees and premiums over which to spread expenses. Health insurance contracts entail certain fixed expenses, resulting in higher expenses as a percent of premium for small groups. o Higher claims due to the unavailability of workers' compensation coverage. Unlike large employers, not all small employers provide workers' compensation benefits to their employees for on the job accidents. As a result, health insurance premiums for these small employers reflect the added cost...
Page 95 - ... IN THAT DIRECTION. YET, FOR VERY PRAGMATIC REASONS, I PREFER THAT CONGRESS ADOPT LEGISLATION SIMILAR TO HR 8, THE UNIVERSAL HEALTH CARE FOR ALL AMERICANS ACT. FOR THE MOST PART, IT IS NOT THE INDIGENT WHO ARE UNINSURED IN OUR COUNTRY. MOST OF THE UNINSURED COME FROM MIDDLE-INCOME, WORKING FAMILIES. I THINK IT IS TERRIBLE THAT HEALTH INSURERS IN OUR NATION SHUT OFF THOSE WHO HAVE A PRE-EXISTING CONDITION. WHEN THE PEPPER COMMISSION HELD HEARINGS IN MY DISTRICT, ONE OF THE WITNESSES WAS A SELF-EMPLOYED...
Page 49 - ... The Employee Benefit Research Institute estimates that 22 percent of selfemployed business owners do not have health insurance coverage. Small businesses face obstacles to providing coverage, almost by definition. Overall, businesses currently face annual health care cost increases averaging nearly 20 percent. Many small businesses have been hit with even larger increases. Administrative, marketing and brokerage costs add 25 to 40 percent to the cost of health insurance premiums for small businesses....
Page 55 - ... of the poor and near-poor who do not have financial access to primary care coverage: A Assure basic Medicaid coverage to all Americans with incomes below the federal poverty level, restoring the original intent of this program and defining clearly the public sector's responsibility. B.
Page 52 - Encouragement of small group pooling arrangements — Group pooling arrangements help small firms to obtain health care coverage on a more cost-effective basis than an individual firm might be able to obtain it. However, confusion exists over the regulatory status of certain pooling arrangements, known as multiple employer welfare arrangements; the Chamber believes that this should be clarified.
Page 58 - PROPOSAL: PROMOTE THE DEVELOPMENT OF NATIONAL MEDICAL PRACTICE STANDARDS TO ASSURE APPROPRIATE AND EFFECTIVE CARE A significant percentage of services delivered in our health care system are Judged by researchers to be either inappropriate or ineffective. Further, research has shown wide variations in the use of procedures across different geographic regions with no apparent medical justification. The development of practice guidelines, review protocols and outcomes-based assessments through a national...

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